OBJECTIVE:To develop the data processing program of Digoxin blood drug concentration(DBDP)and to determine the range of effective blood concentration of Digoxin.METHODS:The DBDP program was developed by VISUAL BASIC6.0and run in Windows95system.The data of blood drug concentration,which was determined with flurescence polarization immunoassay(FPIA)in our hospital,was analyzed with DBDP program and effective blood drug concentration range of Digoxin was set up.RESULTS:The DBDP program integrated functions including pharmacokinetic parameter estimation,establishment of the effective blood drug concentration range,management of the data of the blood drug concentration moni?toring,automatic addition of patient's file,multifunctional fuzzy searching,retrospective analysis and clinical query about drug use.The effective blood drug concentration range of Digoxin was0.58～2.01ng/ml.CONCLUSION:The DBDP program is a very practical tool for the development of therapeutic drug monitoring and it is very necessary to develop blood drug concen?tration monitoring and establish the effective blood drug concentration range.

Objective By investigating the quality and unreasonable prescription of traditional Chinese medicine in our hospital, to analyze the reason and thus put forward the solution and elevate the whole rational administration level in our hospital. Methods 3000 prescriptions prescribed in our hospital from April 2008 to April 2009 were randomly investigated. Select the unreasonable prescriptions and unreasonable use of medicines in a prescription for statistical analysis. Results There were 258 unreasonable prescriptions among spot-check 3000 sheets of prescriptions, reaching 8.6%. There were 633 unreasonable medications, including oversized or excessively small dosage, improper compatibility, repeated medications, etc. Conclusion There is the phenomena of unreasonable prescription in our hospital. Therefore, we should reinforce the management of prescribing medicines and enhance the level of reasonable medication.

Objective:To measure the expression of signal-induced proliferation-associated gene 1 (Sipa1) in gastric cancer and to determine its association with the clinicopathological characteristics and prognosis of patients with gastric carcinoma. Methods:The Sipa1 mRNA and Sipa1 protein expression levels in 43 fresh gastric carcinoma tissues and adjacent normal tissues were measured by real-time PCR and Western blot analysis. The Sipa1 protein expression levels in 122 paraffin blocks of gastric cancer and 64 normal gastric tissues were determined by substance P immunohistochemical technique. Results:The Sipa1 mRNA and Sipa1 protein levels in fresh gastric carcinoma tissues were significantly lower than those in adjacent normal tissues. Sipa1 protein was positive in 36.1%of the paraffin blocks of gastric cancer and in 73.4%of normal gastric tissues. The difference was statistically significant (P<0.05). Sipa1 protein expression was significantly correlated with tumor differentiation, lymphatic metastasis, invasive depth, and clinical stage (P<0.05) but not with age, gender, tumor size, and tumor areas (P>0.05). The five-year survival rates of Sipa1-negative patients were significantly lower than those of Si pa1-positive patients (P<0.01). Conclusion:Sipa1 expression is highly correlated with the biological behavior of gastric carcinoma and thus facilitates the evaluation of gastric carcinoma prognosis.

Objective To investigate the expression and significance of UbcH10 in gastric cancer.Methods The expression of UbcH10 in 117 cases of gastric carcinoma tissues,who were followed up postoperatively,were detected by using immunohistochemistry; The expression among different histological grades and clinical stages are analyzed by statistics; Real-time polymerase chain reaction (Rt PCR) and Western blot method were used to detect the expressions of UbcH10 mRNA and protein in 43 cases of gastric carcinoma tissues and the cancer adjacent normal tissues.Results In paraffin fixed blocks of gastric cancer,positive rate of UbcH10 protein expression was higher than normal gastric tissues (83％ vs 55％,Rs =-0.397,P＜0.01).The difference of UbcH10 expression was not significant in gender,age,tumor site and size of the tumor(Rs =0.369,-0.378,-0.276,0.421,P ＜ 0.05),while it was significantly correlated to tumor differentiation,invasive depth,lymphatic metastasis and clinical stage (Rs =0.369,-0.378,-0.276,0.421,P ＜0.05).UbcH10 and Ki-67 protein and HER-2 expression were in significantly positive correlation (Rs =0.834,Rs =0.281,P ＜ 0.01).UbcH10 mRNA and protein expression in fresh gastric carcinoma tissues was higher than that in their corresponding adjacent normal tissues(ACt =32.2±5.19,4.69 ±1.26,t =26.8,P＜0.01),(0.74±0.45,0.11 ±0.04,t =8.09,P＜0.01).The -5 year patient's survival rate in UbcH10 highly-expressed gastric cancer was higher compared to those with UbcH10 low-expression(x2 =13.116,P ＜0.01).Conclusions UbcH10 is upregulated in gastric cancer,and expression of UbcH10 is closely related to the prognosis of patients with gastric cancer.

Objective To evaluate the clinica1 value of endoscopic placement of colorectal metal stents for malignant colonic obstruction in aged patients. Methods The 82 cases who were older than 65 years with malignant colonic obstruction were randomly divided into colorectal metal stenting group who were treated with endoscopic Niti-S colorectal metal stenting and emergency surgery group who were treated with tumor resection or colostomy. The average length of stay, average hospitalization charge, median survival time, one-year survival rate, perioperative mortality, and the complications such as anastomotic leakage, incision infection were analyzed. Results In colorectal metal stenting group, in 39 of 41 patients, metal stents were successfully inserted, without complications of hemorrhage, perforation and so on. And the symptoms of obstruction were effectively relieved within 2 days. The 17 cases underwent subsequent elective radical resection of colorectal carcinoma after 1 week, without complications of anastomotic leakage. The 22 cases were treated with colorectal metal stenting for palliative treatment. There were 4 cases of stent migration and 5 cases of stent obstruction again. The average length of inhospital stay was (17.9±6.7) days, the average hospitalization charge was 40 047 yuan, the median survival time was (9.4±4.4) months, and one-year survival rate was 43.9%. In emergency surgery group, 13 cases underwent tumor resection and 28 cases received colostomy. The 14 cases presented with multiple organ dysfunction, 8 cases died preoperatively, 4 cases presented with anastigmatic leakage. The average length of stay was (24.4±4.6) day, the average hospitalization charge was 61 867 yuan, the median survival time was (8.8±4.8) months, and one-year survival rate was 36.6%. Conclusions Endoscopic colorectal metal stenting is a safe, economic and effective treatment for malignant colonic obstruction in aged patients, especially reduces the risk of surgical complications, improves the aged patient's quality of life.

Objective To investigate the efficacy and safety of nickel titanium compression anastomosis clip (CAC) in gastrointestinal anastomosis.Methods The clinical data of 413 patients who received gastrointestinal anastomosis with nickel titanium CAC or curved stapler at the First Affiliated Hospital of Fujian Medical University from January 2007 to December 2011 were retrospectively analyzed.All the patients were divided into the CAC group (227 patients) and the curved stapler group (186 patients).The time for gastrointestinal anastomosis,anastomotic bleeding,complications,condition of the incision sites,the first postoperative flatus and time for the excretion of the CAC between the 2 groups were compared.All data were analyzed using the t test or chisquare test.Results The time for gastrointestinal anastomosis of the CAC group was (8.3 ± 2.5) minutes,which was significantly shorter than (18.7 ± 3.6) minutes of the curved stapler group (t =5.74,P ＜ 0.05).There were no significant difference in the time of postoperative flatus,duration of hospital stay and costs between the 2 groups (t =0.27,1.32,3.11,P ＞ 0.05).No patients in the CAC group had anastomotic bleeding,while the incidence of anastomotic bleeding of the curved stapler group was 3.23 ％ (6/186),with a significant difference between the 2 groups (x2=7.43,P ＜ 0.05).The incidences of gastric emptying dysfunction of the CAC group and the curved stapler group were 0.88％ (2/227) and 1.08％ (2/186),with no significant difference between the 2 groups (x2=0.04,P ＞ 0.05).The incidences of postoperative anastomotic stricture and anastomositis were 0 (0/227) and 11.01％ (25/227) in the CAC group,and 2.15％ (4/186) and 21.50％ (40/186) in the curved stapler group,with significant differences between the 2 groups (x2 =4.93,8.49,P ＜ 0.05).No anastomotic fistula was detected in the 2 groups.The CAC was excreted at postoperative day 12-26.Conclusion CAC is safe and effective for gastrointestinal anastomosis.

Objective To investigate the etiology,characteristics of upper gastrointestinal bleeding (UGIB) in China,and to investigate the main causes of different population.Methods Literature on the causes of UGIB were retrieved and screened according to strict inclusion and exclusion standards.Results A total of 15733 UGIB patients were enrolled in the study.The most common causes of UGIB were duodenal ulcer (31.2％),gastric ulcer (15.2％),acute gastric mucosal lesions (AGML) (12.0％),cancer (11.7％),and esophageal varices (11.3％).The incidences of duodenal ulcer,gastric ulcer,AGML,esophageal varices,cancer were 32.3％,15.1％,12.1％,7.2％,and 12.5％ before 2006,and 29.7％,15.4％,11.1％,15.3％,and 10.9％ after 2006.The ratio of male to female was 3.25: 1.The most common causes of UGIB in older patients were gastric ulcer,cancer,AGML,duodenal ulcer,esophageal varices,while those in children were duodenal ulcer,gastric ulcer and AGML.Conclusion Peptic ulcers,AGML,cancer and esophageal varices were the most common causes of UGIB in China.The causes of UGIB have changed significantly in the past 5 years (P ＜0.01).

Objective To study neuromechanism for uremic restless syndrome (URLS),functional MRI (fMRI) analysis and were used to explor main activity.Methods Resting state functional magnetic resonance imaging (MRI) was performed on 29 patients with uremic restless legs syndrome and 25 healthy controls.The values of the regional homogeneity (ReHo) of the two groups were calculated and analyzed statistically.Result As compared with the control group,patients with uremic restless legs syndrome showed emotional and mental abnormality.Increased ReHo values in bilateral supplementary motor area,bilateral thalamus,left insular lobe,left hippocampus (P＜0.05),and decreased ReHo values in anterior cingulate gyrus,bilateral posterior central gyrus,right amygdala were found in patients with uremic restless legs syndrome (P＜0.05).The severity score of RLS was respectively positively correlated with dialysis duration (r =0.57,P =0.002),PTH level (r =0.419,P =0.033)BAI (r =0.528,P=0.006),and BDI (r =0.567,P =0.003).Conclusion Neuronal activity in related brain area in patients with uremic restless legs syndrome were found.This abnormality provides an objective diagnostic basis for the explanation of restless legs syndrome in maintenance hemodialysis patients.

Objective To investigate the impact of splenectomy on the prognosis and immune function of patients with end stage carcinoma of the esophagogastric.Methods The clinical data of 61 patients with end stage carcinoma of the esophagogastric junction who were admitted to the First Affiliated Hospital of Fujian Medical University from January 2007 to December 2010 were retrospectively analyzed.All the patients were divided into splenectomy group (22 patients) and spleen preservation group (39 patients).The immune function before operation,on the 10th day and the 6th month after operation was detected.The intra-and postoperative conditions of the patients of the 2 groups were compared.All data were analyzed using the independent sample t test or chisquare test.Results The levels of IgA,IgG,IgM,CD3 and CD4 in the splenectomy group at the 10th day after operation were significantly higher than those before operation (t =2.55,3.33,3.40,2.92,2.10,P ＜ 0.05).The levels of IgA,IgG,IgM,CD3,CD4,the ratio of CD4/CD8 of the spleen preservation group at the 10th day after operation were significantly higher than those before operation (t =3.35,5.29,3.33,2.60,3.53,3.12,P ＜0.05).The levels of IgA,IgG,IgM,CD3,CD4 and the ratio of CD4/CD8 in the splenectomy group at postoperative month 6 were significantly lower than those at postoperative day 10 (t ＝2.75,4.40,3.06,2.51,2.24,2.29,P ＜ 0.05).The levels of IgA,IgG,IgM,CD4,CD8 and the ratio of CD4/CD8 of the spleen preservation group were significantly higher than those of the splenectomy group,while the level of CD8 in the spleen preservation group was significantly lower than that in the splenectomy group (t =1.70,2.10,2.70,2.16,2.13,2.83,P ＜ 0.05).The operation time of the splenectomy group was (152 ± 26) minutes,which was significantly longer than (130 ± 24) minutes of the spleen preservation group (t ＝ 3.42,P ＜ 0.05).There were no significant differences in the operative blood loss,incidence of postoperative infection,median survival time,1-year survival rate between the 2 groups (t =1.38,x2 =0.78,1.22,2.51,P ＞ 0.05).Conclusion Palliative gastrectomy could reverse the immune function of spleen by decreasing tumor burden for patients with end stage carcinoma of the esophagogastric junction who can not be treated by radical resection.Spleen preservation may have positive significance for the immune function and prognosis of patients with end stage carcinoma of the esophagogastric junction.